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Thread: Medicare and Glasses - New Legislature coming?

  1. #1
    OptiBoard Professional KrystleClear's Avatar
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    Medicare and Glasses - New Legislature coming?

    https://www.cnbc.com/2021/07/14/medi...ts-budget.html

    https://www.forbes.com/sites/howardg...h=5138bb825701

    https://www.npr.org/sections/health-...aring-benefits

    So... if this is passed and plain old Medicare starts covering glasses (outside of the post-cataract pair they get), how will it change things for you?

    About 80% of our patients are of Medicare age. Older folks on fixed incomes can't always buy a new pair each year, as Medicare doesn't cover it. The only vision plan we accept is VSP, so most that have a vision plan with their Medicare supplement or Medicare advantage plan end up paying out of pocket to us anyway as we don't accept Davis, NVA, etc.. On one hand, I know that if Medicare starts covering glasses, we'll get a lot more glasses orders. On the other hand, I wonder how they plan to roll this out and how complicated it will be. Will the glasses be billed through DMERC like the post-cataract glasses are currently billed? Or will they assign separate vision plans? And if they have a supplement or advantage plan with an existing vision plan would that make them ineligible through standard Medicare? Will it be subject to their deductible? It's going to take us a lot more time to determine eligibility and to devote time to submitting claims. Not sure how that's going to play out. I wonder if they will have the same benefit allowances as the current benefit for post-cataract surgery glasses...

    Do you think this will pass? Do you even want it to pass? I feel like dental and vison *should* be covered for those on Medicare. We have many older patients who make do with old, broken glasses with lens powers that are no longer what they need because they can't afford to get new ones. I am wondering if when and if this bill comes to pass, if there will be a big influx of Medicare patients rushing in to get glasses.
    Krystle

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    I predict the vision eye glass benefit will be taken out.

    Maybe not the exam but that may not be a bad thing.

    Depends on what Essilor wants.

  3. #3
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    With more than adequate quality suppliers that are easily accessible—such as Costco, Zenni and WP—I see no need for expanded Medicare coverage for glasses.

    B

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    What's up? drk's Avatar
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    I don't either.

    The Medicare Advantage plans offer all those goofy bells and whistles (FREE EYE EXAMS! GLASSES! HEARING AIDS!) so I think that's where HHS (or the give-away pander-bears in Washington, D.C.) got the bright idea.

    Totally not needed.

    I don't think we'll see it.

  5. #5
    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Uncle Fester View Post

    Depends on what Essilor wants.
    Good point!!
    Krystle

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    From today's Washington Post:

    "He has floated the idea of giving seniors a debit card loaded with $800 to spend on dental benefits as part of an expansion of Medicare."

    https://www.washingtonpost.com/

    Should have become a dentist right OD's?

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    Quote Originally Posted by Uncle Fester View Post
    I predict the vision eye glass benefit will be taken out.

    Maybe not the exam but that may not be a bad thing.

    Depends on what Essilor wants.
    yup..all of this.

  8. #8
    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    From today's Washington Post:

    "He has floated the idea of giving seniors a debit card loaded with $800 to spend on dental benefits as part of an expansion of Medicare."

    https://www.washingtonpost.com/

    Should have become a dentist right OD's?

    Now if they did that for vision, I'd be on board! Makes it all so less complicated and patients could get a quality set of eyeglasses. I am sure there are easier ways to verify Medicare eligibility and deductibles now but when I first started as an optometry receptionist/pre-exam tech back in 2011 I had to call Medicare for each patient and sit through the automation to get the information I needed. Sometimes the system would be completely down. And lord help you if you had to speak to a human being.

    $800 doesn't get you very far with dental though. They always find something wrong and the solution is never cheap.
    Krystle

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by KrystleClear View Post

    $800 doesn't get you very far with dental though. They always find something wrong and the solution is never cheap.
    But yes it is cheap for the skill needed to fix it correctly and keep gum disease, crowns, implants or dentures out of your life!!!

    Who among us scrupulously follows preventative measures to keep our teeth and gums healthy? If you do then chances are not much is found in visits.

    Kind of like properly fitted eyeglasses from qualified opticians helping you see.

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    The problem with a flat dollar amount like an $800 dollar prepaid card for glasses is that providers will try and figure out how to get as much of that $800 dollars as possible. Cheapest frames and lenses possible, marked up as much as possible. Obviously not every provider, but a lot of them.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Kwill212 View Post
    The problem with a flat dollar amount like an $800 dollar prepaid card for glasses is that providers will try and figure out how to get as much of that $800 dollars as possible. Cheapest frames and lenses possible, marked up as much as possible. Obviously not every provider, but a lot of them.
    A market to turn them into cash will also appear. I'd speculate especially in unlicensed states.

    Hmmm....Maybe only redeemable from MD's and OD's and chains?

    Eye Med and VSP providers only with Frames Direct for internet??

    Now there's a lobbiest campaign!!!
    Last edited by Uncle Fester; 10-26-2021 at 02:36 PM. Reason: Bwahahaa......

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    Quote Originally Posted by Uncle Fester View Post
    A market to turn them into cash will also appear. I'd speculate especially in unlicensed states.

    Hmmm....Maybe only redeemable from MD's and OD's and chains?

    Eye Med and VSP providers only with Frames Direct for internet??

    Now there's a lobbiest campaign!!!
    Sounds like the perfect government program. How to turn a $100 dollar pair of glasses into an $800 dollar pair of glasses.

  13. #13
    OptiBoard Professional KrystleClear's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    But yes it is cheap for the skill needed to fix it correctly and keep gum disease, crowns, implants or dentures out of your life!!!

    Who among us scrupulously follows preventative measures to keep our teeth and gums healthy? If you do then chances are not much is found in visits.

    Kind of like properly fitted eyeglasses from qualified opticians helping you see.
    I just think they should give a lot more. I don't think you could find a pair of dentures for $800. Maybe off of Wish! They should come up with a Zenni Optical but for dental appliances. People will be walking around with George Washington chompers. Scary!!!
    Krystle

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Looks like it's going to be just expanded Medicare coverage for hearing only.

    https://tinyurl.com/3dz9ets7

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    What's up? drk's Avatar
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    Oh, rats.

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